TY - JOUR T1 - The Mechanical Ventilation – Respiratory Distress Observation Scale (MV-RDOS) as a surrogate of self-reported dyspnea in intubated patients JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00598-2018 SP - 1800598 AU - Maxens Decavèle AU - Frédérick Gay AU - Romain Persichini AU - Julien Mayaux AU - Capucine Morélot-Panzini AU - Thomas Similowski AU - Alexandre Demoule Y1 - 2018/09/12 UR - http://erj.ersjournals.com/content/early/2018/09/06/13993003.00598-2018.abstract N2 - Intensive care unit (ICU) patients are exposed to many sources of discomfort, among which dyspnea is one of the more severely distressing [1]. In invasively mechanically ventilated patient, dyspnea is frequent (47% of intubated patients report breathing discomfort when they first can communicate with caregivers) and severe (median rating of 5 on a dyspnea visual analogic scale [D-VAS]; association with anxiety and neurovegetative signs of stress) [2]. It is often linked to ventilator settings and seems to be associated with poorer clinical outcomes (e.g. delayed extubation, post-traumatic stress disorders) [2, 3]. As in other settings, identifying and quantifying dyspnea in mechanically ventilated patients is therefore a major clinical stake. This is challenging because self-report and self-assessment, prerequisites for D-VAS assessment [4], are often impossible or very difficult in this setting. Unfortunately, caregivers markedly underestimate dyspnea in this context [5, 6]. The risk of occult respiratory suffering is therefore major in the ICU setting, and neglecting it would amount to a fault [7].FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Dr. Decavèle has nothing to disclose.Conflict of interest: Dr. Gay has nothing to disclose.Conflict of interest: Dr. Persichini has nothing to disclose.Conflict of interest: Dr. Mayaux has nothing to disclose.Dr. Morelot-Panzini has nothing to disclose.Conflict of interest: Dr. Similowski reports personal fees from AstraZeneca, personal fees from Invacare, personal fees from Chiesi, personal fees from Lungpacer Inc., personal fees from TEVA, personal fees from Novartis, personal fees from GSK, personal fees from Boerhinger Ingelheim France, outside the submitted work; In addition, Dr. Similowski has a patent brain-ventilator interface licensed to Air Liquide Medical Systems and MyBrainTechnology, a patent protection device for intubation pending, and a patent non-contact thoracic movement imaging system pending.Conflict of interest: Dr. Demoule reports other from Philips, personal fees from Medtronic, personal fees from Fisher & Paykel, personal fees from Baxter, outside the submitted work. ER -